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Individual
DR. IGGY MAYBORODA
Active
Individual
DR. IGGY MAYBORODA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N.D.
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
099.0084660
VT
175F00000X
Naturopath
ND-535
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
099.0084660
CREDENTIAL #
VT
01
—
NDF-535
STATE LICENSE
CA
Enumeration date
03/12/2012
Last updated
10/02/2013
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